Abstract
A custom built coherent anti-Stokes Raman scattering (CARS) microscope was used to image prostatic glands and nerve structures from 17 patients undergoing radical prostatectomy. Imaging of glandular and nerve structures showed distinctive cellular features that correlated to histological stains. Segmentation of cell nucleus was performed to establish a cell feature-based model to separate normal glands from cancer glands. In this study, we use a single parameter, average cell neighbor distance based on CARS imaging, to characterize normal and cancerous glandular structures. By combining CARS with our novel classification model, we are able to characterize prostate glandular and nerve structures in a manner that potentially enables real-time, intra-operative assessment of surgical margins and neurovascular bundles. As such, this method could potentially improve outcomes following radical prostatectomy.
Highlights
Prostate cancer remains a global health concern, accounting for approximately 900,000 new cases annually worldwide [1]
In an effort to improve intra-operative decision-making with respect to surgical plane dissection and erectile function recovery, we sought to test the feasibility of utilizing coherent anti-Stokes Raman scattering (CARS) technology to visualize prostate and nerve tissues
The optical source system is composed of an optical parametric oscillator (OPO) and an Nd:YVO4 laser
Summary
Prostate cancer remains a global health concern, accounting for approximately 900,000 new cases annually worldwide [1]. Radical prostatectomy is the most common treatment for men diagnosed with clinically localized prostate disease in the Western world. In this surgical procedure, the entire prostate is removed, and the bladder is reconnected to the urethra [2]. The three main domains assessed to determine radical prostatectomy efficacy are cancer control and post-operative urinary and erectile function [3]. In an effort to improve intra-operative decision-making with respect to surgical plane dissection (i.e., surgical margins) and erectile function recovery (i.e., neurovascular bundle preservation), we sought to test the feasibility of utilizing CARS technology to visualize prostate and nerve tissues
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